[Congressional Record Volume 162, Number 74 (Wednesday, May 11, 2016)]
[House]
[Pages H2263-H2266]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   IMPROVING TREATMENT FOR PREGNANT AND POSTPARTUM WOMEN ACT OF 2016

  Mr. GUTHRIE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 3691) to amend the Public Health Service Act to reauthorize 
the residential treatment programs for pregnant and postpartum women 
and to establish a pilot program to provide grants to State substance 
abuse agencies to promote innovative service delivery models for such 
women, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 3691

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Improving Treatment for 
     Pregnant and Postpartum Women Act of 2016''.

     SEC. 2. REAUTHORIZATION OF RESIDENTIAL TREATMENT PROGRAMS FOR 
                   PREGNANT AND POSTPARTUM WOMEN.

       Section 508 of the Public Health Service Act (42 U.S.C. 
     290bb-1) is amended--
       (1) in subsection (p), in the first sentence, by inserting 
     ``(other than subsection (r))'' after ``section''; and
       (2) in subsection (r), by striking ``such sums'' and all 
     that follows through ``2003'' and inserting ``$16,900,000 for 
     each of fiscal years 2017 through 2021''.

     SEC. 3. PILOT PROGRAM GRANTS FOR STATE SUBSTANCE ABUSE 
                   AGENCIES.

       (a) In General.--Section 508 of the Public Health Service 
     Act (42 U.S.C. 290bb-1) is amended--
       (1) by redesignating subsection (r), as amended by section 
     2, as subsection (s); and
       (2) by inserting after subsection (q) the following new 
     subsection:
       ``(r) Pilot Program for State Substance Abuse Agencies.--
       ``(1) In general.--From amounts made available under 
     subsection (s), the Director of the Center for Substance 
     Abuse Treatment shall carry out a pilot program under which 
     competitive grants are made by the Director to State 
     substance abuse agencies to--
       ``(A) enhance flexibility in the use of funds designed to 
     support family-based services for pregnant and postpartum 
     women with a primary diagnosis of a substance use disorder, 
     including opioid use disorders;
       ``(B) help State substance abuse agencies address 
     identified gaps in services furnished to such women along the 
     continuum of care, including services provided to women in 
     nonresidential based settings; and
       ``(C) promote a coordinated, effective, and efficient State 
     system managed by State substance abuse agencies by 
     encouraging new approaches and models of service delivery.
       ``(2) Requirements.--In carrying out the pilot program 
     under this subsection, the Director shall--
       ``(A) require State substance abuse agencies to submit to 
     the Director applications, in such form and manner and 
     containing such information as specified by the Director, to 
     be eligible to receive a grant under the program;
       ``(B) identify, based on such submitted applications, State 
     substance abuse agencies that are eligible for such grants;

[[Page H2264]]

       ``(C) require services proposed to be furnished through 
     such a grant to support family-based treatment and other 
     services for pregnant and postpartum women with a primary 
     diagnosis of a substance use disorder, including opioid use 
     disorders;
       ``(D) not require that services furnished through such a 
     grant be provided solely to women that reside in facilities;
       ``(E) not require that grant recipients under the program 
     make available through use of the grant all services 
     described in subsection (d); and
       ``(F) consider not applying requirements described in 
     paragraphs (1) and (2) of subsection (f) to applicants, 
     depending on the circumstances of the applicant.
       ``(3) Required services.--
       ``(A) In general.--The Director shall specify a minimum set 
     of services required to be made available to eligible women 
     through a grant awarded under the pilot program under this 
     subsection. Such minimum set--
       ``(i) shall include requirements described in subsection 
     (c) and be based on the recommendations submitted under 
     subparagraph (B); and
       ``(ii) may be selected from among the services described in 
     subsection (d) and include other services as appropriate.
       ``(B) Stakeholder input.--The Director shall convene and 
     solicit recommendations from stakeholders, including State 
     substance abuse agencies, health care providers, persons in 
     recovery from substance abuse, and other appropriate 
     individuals, for the minimum set of services described in 
     subparagraph (A).
       ``(4) Duration.--The pilot program under this subsection 
     shall not exceed 5 years.
       ``(5) Evaluation and report to congress.--The Director of 
     the Center for Behavioral Health Statistics and Quality shall 
     fund an evaluation of the pilot program at the conclusion of 
     the first grant cycle funded by the pilot program. The 
     Director of the Center for Behavioral Health Statistics and 
     Quality, in coordination with the Director of the Center for 
     Substance Abuse Treatment shall submit to the relevant 
     committees of jurisdiction of the House of Representatives 
     and the Senate a report on such evaluation. The report shall 
     include at a minimum outcomes information from the pilot 
     program, including any resulting reductions in the use of 
     alcohol and other drugs; engagement in treatment services; 
     retention in the appropriate level and duration of services; 
     increased access to the use of medications approved by the 
     Food and Drug Administration for the treatment of substance 
     use disorders in combination with counseling; and other 
     appropriate measures.
       ``(6) State substance abuse agencies defined.--For purposes 
     of this subsection, the term `State substance abuse agency' 
     means, with respect to a State, the agency in such State that 
     manages the Substance Abuse Prevention and Treatment Block 
     Grant under part B of title XIX.''.
       (b) Funding.--Subsection (s) of section 508 of the Public 
     Health Service Act (42 U.S.C. 290bb-1), as amended by section 
     2 and redesignated by subsection (a), is further amended by 
     adding at the end the following new sentence: ``Of the 
     amounts made available for a year pursuant to the previous 
     sentence to carry out this section, not more than 25 percent 
     of such amounts shall be made available for such year to 
     carry out subsection (r), other than paragraph (5) of such 
     subsection. Notwithstanding the preceding sentence, no funds 
     shall be made available to carry out subsection (r) for a 
     fiscal year unless the amount made available to carry out 
     this section for such fiscal year is more than the amount 
     made available to carry out this section for fiscal year 
     2016.''.

     SEC. 4. CUT-GO COMPLIANCE.

       Subsection (f) of section 319D of the Public Health Service 
     Act (42 U.S.C. 247d-4) is amended by striking ``through 
     2018'' and inserting ``through 2016, $133,300,000 for fiscal 
     year 2017, and $138,300,000 for fiscal year 2018''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Kentucky (Mr. Guthrie) and the gentleman from Texas (Mr. Gene Green) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Kentucky.


                             General Leave

  Mr. GUTHRIE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and insert extraneous materials in the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Kentucky?
  There was no objection.
  Mr. GUTHRIE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of H.R. 3691, the Improving Treatment 
for Pregnant and Postpartum Women Act of 2015, introduced by my 
colleagues on the Energy and Commerce Committee, Mr. Ben Ray Lujan of 
New Mexico, Mr. Tonko of New York, Ms. Clarke of New York, Ms. Matsui 
of California, and Mr. Cardenas of California.
  In most instances, withdrawal or detoxification is not clinically 
appropriate for pregnant women with opioid use disorders. The 
withdrawal symptoms associated with discontinuing opioid use in 
pregnant women can lead to miscarriage or other negative birth 
outcomes. Buprenorphine and methadone can be used to treat a woman's 
opioid use disorder while pregnant. Such treatment can result in 
improved outcomes for both mothers and babies.
  Unfortunately, babies exposed to opioids in utero may be born with 
neonatal abstinence syndrome, NAS, which refers to medical issues 
associated with opioid withdrawal in newborns. Mothers suffering from 
opioid use disorder may be sent home with babies who have NAS with very 
little guidance or support, which can have negative consequences for 
their babies.
  NAS can result from the use of prescription opioids as prescribed for 
medical reasons, abuse of prescription opioid medication, or the use of 
illegal opioids like heroin.
  The grant program reauthorized in H.R. 3691 helps support residential 
treatment facilities where women and their children receive support, 
education, treatment, and counseling that they need to address opioid 
addiction and NAS. The newly created pilot program will allow States 
more flexibility in providing these services for women and children in 
need.
  Mr. Speaker, I urge my colleagues to support this legislation.
  I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise and voice my support for H.R. 3691, the Improving 
Treatment for Pregnant and Postpartum Women Act. The Pregnant and 
Postpartum Women--PPW--program is administered by the Substance Abuse 
and Mental Health Services Administration--SAMHSA--Center for Substance 
Abuse Treatment.
  The program was designed to expand the availability of comprehensive 
residential substance abuse treatment, prevention, and recovery support 
services for pregnant and postpartum women and their children. The 
program provides grants to public and nonprofit private entities to 
provide substance use disorder treatment to women in residential 
facilities.
  For too long our laws have taken a punitive approach with pregnant 
women and new mothers suffering from addiction. Criminal approaches 
have failed to work. Solutions should emphasize a nonpunitive, public 
health approach like the PPW program.
  Substance abuse treatment that supports the family as a unit has 
proven effective for maintaining sobriety and enhancing child well-
being. Given the magnitude of this epidemic, there is a need for 
increased availability of treatment options that are responsive to 
women's complex responsibilities.
  H.R. 3691 reauthorizes residential treatment programs for pregnant 
and postpartum women. This vital program provides for substance use 
treatment for women in need as well as their minor children. Family-
based treatment services include individual and family counseling, 
prenatal and postpartum care, and training on parenting.
  The bill will also create a pilot program to allow up to 25 percent 
of the grants to be made for outpatient treatment services. This will 
give State substance abuse agencies greater flexibility to provide 
access to treatment and address gaps in delivery of care for pregnant 
and postpartum women, including services in nonresidential settings, 
and encourage new approaches of services available to pregnant women 
along the continuum of care.
  I want to thank the bill's sponsor, Representative Ben Ray Lujan, who 
is a member of the Energy and Commerce Committee and the Health 
Subcommittee, for his leadership in introducing this bill.
  I urge my colleagues to support the Improving Treatment for Pregnant 
and Postpartum Women Act.
  I reserve the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I yield 3 minutes to the gentleman from 
Georgia (Mr. Carter).
  Mr. CARTER of Georgia. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker, I rise today in support of H.R. 3691 so that pregnant 
and postpartum women can receive comprehensive, residential substance 
abuse treatment when fighting opioid drug addiction.
  According to the National Perinatal Association, 4 percent of all 
live births in the U.S. occur in women who abuse illicit or 
prescription drugs, such as

[[Page H2265]]

opioid pain relievers. This would equate to 159,436 births in 2014 from 
women who abuse illicit or prescription drugs.
  This is simply unacceptable. We must take action to ensure that 
pregnant and postpartum women receive the care they need to protect 
American families.
  H.R. 3691 simply states that support should be extended for 
residential substance abuse treatment programs for pregnant and 
postpartum women through 2020 and the Center for Substance Abuse 
Treatment should carry out a pilot program to make grants to State 
substance abuse agencies to support services for pregnant and 
postpartum women who have a substance abuse disorder.
  By extending these services and working through this pilot program, 
we can ensure that pregnant and postpartum women can receive the care 
that they need so that they can care for their families. That is why I 
am supporting H.R. 3691.
  I encourage my colleagues to support this bill so we can extend care 
to all mothers and soon-to-be mothers who fight drug addiction.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield 5 minutes to the 
gentleman from New Mexico (Mr. Ben Ray Lujan), the cosponsor of the 
bill.
  Mr. BEN RAY LUJAN of New Mexico. Mr. Speaker, I would like to start 
by thanking the chairman and ranking member of the Energy and Commerce 
Committee and the Subcommittee on Health for their bipartisan efforts 
to address the Nation's drug crisis and for advancing my legislation, 
the Improving Treatment for Pregnant and Postpartum Women Act.
  Our Nation continues to face a substance abuse crisis that is tearing 
apart communities and families. In New Mexico, we have seen a crisis 
that is multi-generational, with people growing up in communities where 
abuse is commonplace.
  The grant program for residential treatment that my bill enhances is 
an important part of our effort to break the cycle of drug abuse that 
grips our communities. My bill would also increase funding for the 
Pregnant and Postpartum Women grant.
  As originally written, my bill contained an authorization of $40 
million, significantly above the current level, to avoid any cuts to 
existing residential programs. Through bipartisan cooperation, we 
arrived at a small increase over the next 5 years.
  By focusing on women with young children and soon-to-be mothers, we 
help ensure that these families get on the right path from the very 
beginning. People want to be better. But, unfortunately, too often 
there are too few resources and avenues for help.
  Certainly this is true in New Mexico, which is among the States most 
impacted by the epidemic plaguing our country. Too many people are 
suffering, and too many people are being shut out from access to help.
  This bill helps address this by creating a demonstration project in 
the existing Pregnant and Postpartum Women grant program to allow 
grants to be used for nonresidential care.
  Residential programs are critically important where they are 
available. In my home State of New Mexico, there are far too few 
residential programs to serve the needs of my constituents. In 
addition, many of the existing facilities have wait lists. With New 
Mexico's vastness, residential facilities are out of reach for too 
many.
  That is why this demonstration project is critical. It will allow us, 
while continuing to support residential treatment programs, to explore 
how to ensure the services and care we are providing work for those in 
need.
  While I am pleased that we have been able to work together across the 
aisle in an effort to authorize increased funding and ensure the 
inclusion of the demonstration project, I think it is important to say 
more must be done.
  Supporting residential facilities and innovation to make treatment 
more available is essential, and both will require significant 
investments.
  Mr. Speaker, in 2014, 47,055 people died from drug overdoses. That is 
129 people per day. We must do more.
  I hope that, as we continue this conversation beyond today, we can 
all come to recognize the need for funding above and beyond what we are 
doing today.
  I respectfully ask for support of this bill.
  Mr. GUTHRIE. Mr. Speaker, I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield 5 minutes to the 
gentlewoman from Texas (Ms. Jackson Lee), my colleague and neighbor 
from Houston.
  Ms. JACKSON LEE. Mr. Speaker, let me congratulate the gentleman from 
Texas for his leadership and the gentleman from New Mexico for his 
outstanding leadership on this important legislation and his concern 
and passion.
  Let me thank my friends who are managing the legislation and let the 
American people know and our colleagues know that we are continuing our 
commitment on dealing with the issues of addiction, in this instance, 
opioid. And, of course, we know that there are other forms of 
addiction, from alcohol, to crack, to cocaine, but we are moving 
forward.
  I rise to support H.R. 3691, the Improving Treatment for Pregnant and 
Postpartum Women Act of 2015. It is clear that this is an issue that 
has plagued both the woman and as well the newborn baby.
  Let me offer to say that President Obama has updated that guideline 
to encourage doctors to be more cautious when prescribing opioid 
painkillers and to emphasize nonopioid therapies for certain 
conditions. Many times women who are pregnant are under treatment.
  Additionally, the Obama administration has awarded $94 million to 
community health centers to improve and expand the delivery of 
substance abuse services. In the President's FY 2017 budget, the 
administration proposed $1.1 billion to combat drug addition 
considering modifying certain rules to improve treatment.
  As misuse of opioids have increased over the past decade, so has the 
incidence of neonatal abstinence syndrome, referring to the medical 
effects on newborn infants suffering from drug withdrawal because their 
mothers were drug addicts.
  The GAO report found that a lack of available treatment programs for 
pregnant women and newborns with neonatal abstinence syndrome, 
including the availability of comprehensive care and enabling services, 
such as transportation and child care, has hampered Federal efforts to 
address the issue.

                              {time}  1730

  I am glad that this bill, which is why I rise to support it, 
reauthorizes residential treatment grant programs for pregnant and 
postpartum women who have substance abuse problems--programs that are 
administered by the Health and Human Service Department's Center for 
Substance Abuse Treatment, increasing the authorized funding level by 6 
percent. This gives me an opportunity to say that, with regard to all 
of these bills, I know that we will all join together to make sure the 
right funding is available for these bills to really work.
  I join in support of this legislation and add to it legislation that 
I have introduced, Improving Safe Care for the Prevention of Infant 
Abuse and Neglect Act, and, which I introduced recently, the Stop 
Infant Mortality and Recidivism Reduction Act of 2016, which will help 
the Federal Bureau of Prisons to improve the effectiveness and 
efficiency of the Federal prison system for pregnant offenders by 
establishing a pilot program of critical stage development nurseries in 
Federal prisons for children born to inmates. Likewise, at that time, 
one may discover the concerns that are being expressed here today.
  However, the Improving Treatment for Pregnant and Postpartum Women 
Act of 2016, also establishes a pilot program to provide grants to 
State substance abuse agencies to promote innovative service delivery 
models for pregnant women who have a substance use disorder, such as 
opioid addiction, including for family-based services in nonresidential 
settings.
  This is a good bill because it is more than the adult who is being 
treated here. It is a good bill because we are concerned about the 
newborn, the innocent baby who needs to have a start in life. In this 
instance, this legislation will both treat the mother and provide 
assistance--residential and nonresidential care--so that these 
individuals can have the starts in life that they need.
  Let us be reminded of the fact that this addiction of these drugs 
becomes

[[Page H2266]]

an illness. We have seen overdoses that cause the loss of life. Let us 
be part of stemming the tide, but, more importantly, let us help those 
who are trying to hang onto life and to start a new life. This 
legislation does that, and I ask my colleagues to support it.
  Again, I thank the gentleman from Texas for his leadership, and I 
thank him for yielding to me.
  Mr. Speaker, I rise in support of H.R. 3691, the ``Improving 
Treatment for Pregnant & Postpartum Women Act of 2015,'' that was 
approved by the Energy and Commerce Committee.
  In the past decade and a half, the growth in the number of physicians 
prescribing opioids to help patients deal with pain from surgeries, 
dental work and chronic conditions has resulted in an increasing number 
of patients becoming dependent on the powerful and highly addictive 
painkillers--with patients not only abusing the use of those 
painkillers but often turning to heroin once their opioid prescription 
ended.
  The Centers for Disease Control and Prevention reports that nearly 
259 million opioid prescriptions were written in 2012, more than enough 
for every adult in the United States.
  It is estimated that in 2013 nearly 4.5 million people in the United 
States without a valid medical need were using prescription 
painkillers.
  The Health and Human Services Department estimates that the number of 
unintentional overdose deaths from prescription painkillers almost 
quadrupled between 1999 and 2013.
  Abuse of prescription opioids now kills nearly 30,000 Americans each 
year.
  Both states and the federal government have begun responding to this 
growing public health crisis, with many states moving to make anti-
overdose drugs more available and shield first-responders from 
liability in administering those drugs.
  President Obama, meanwhile, has updated prescribing guidelines to 
encourage doctors to be more cautious when prescribing opioid 
painkillers and to emphasize non-opioid therapies for certain 
conditions.
  Additionally, the Obama administration has awarded $94 million to 
community health centers to improve and expand the delivery of 
substance abuse services.
  In the president's FY 2017 budget the administration proposed $1.1 
billion to combat drug addiction, considering modifying certain rules 
to improve treatment.
  As misuse of opioids has increased over the past decade, so has the 
incidence of neonatal abstinence syndrome, referring to the medical 
effects on newborn infants suffering from drug withdrawal because their 
mothers were drug addicts.
  A 2015 Government Accountability Office (GAO) report found that a 
lack of available treatment programs for pregnant women and newborns 
with neonatal abstinence syndrome, including the availability of 
comprehensive care and enabling services such as transportation and 
child care, has hampered federal efforts to address the issue.
  This bill reauthorizes residential treatment grant programs for 
pregnant and postpartum women who have substance abuse problems that 
are administered by the Health and Human Services (HHS) Department's 
Center for Substance Abuse Treatment, increasing the authorized funding 
level by 6%.
  Seeking to right the same wrongs as H.R. 4843, the ``Improving Safe 
Care for the Prevention of Infant Abuse and Neglect Act,'' I introduced 
the, ``Stop Infant Mortality and Recidivism Reduction Act of 2016,'' or 
the ``SIMARRA Act,'' which will help the Federal Bureau of Prisons to 
improve the effectiveness and efficiency of the Federal prison system 
for pregnant offenders, by establishing a pilot program of critical-
stage, developmental nurseries in Federal prisons for children born to 
inmates.
  It is time that our nation recognizes a long-persistent need to break 
the cycle of generational, institutional incarceration amongst mothers 
serving time for non-violent crimes and the children they birth behind 
prison bars.
  H.R. 5130, the, ``SIMARRA Act of 2016,'' gives those infants born to 
incarcerated mothers a chance to succeed in life.
  ``SIMARRA'' is not merely yet another second chance program, 
demanding leniency from the criminal justice system.
  Instead, H.R. 5130 asks our national criminal justice system what it 
can do for those young Americans born and relegated to a life of nearly 
impossible odds of survival.
  ``SIMARRA'' provides that first chance--a first chance for American 
infants--that many of their mothers, born themselves to mothers behind 
bars, never received.
  The ``Improving Treatment for Pregnant & Postpartum Women Act of 
2015,'' also establishes a pilot program to provide grants to state 
substance abuse agencies to promote innovative service delivery models 
for pregnant women who have a substance use disorder, such as opioid 
addiction, including for family-based services in nonresidential 
settings.
  Of the amounts appropriated for the HHS residential treatment 
program, up to 25% would be available to carry out the pilot program.
  No funds would be made available to carry out the pilot program for a 
fiscal year, however, unless the amount made available to carry out the 
residential treatment program for the fiscal year is more than the 
comparable amount made available for FY 2016.
  The Senate on March 10, 2016, passed by a 94-1 vote, S 524, an 
antiopioid abuse bill that would authorize grants for opioid treatment 
services and first-responder training in using anti-overdose drugs, as 
well as create a task force to review and update best practices for 
prescribing pain medication.
  The measure offsets the increased authorization through a $5 million 
reduction in the existing FY 2017 authorization for Centers for Disease 
Control (CDC) public health capability enhancement activities.
  Under current law, $138.3 million is authorized for those activities 
each year through FY 2018.
  The Congressional Budget Office (CBO) has not yet released a cost 
estimate for the bill.
  H.R. 3691 would also mandate investigations into heroin distribution 
and unlawful distribution of prescription opioids, and require the 
creation of a national drug awareness campaign that takes into account 
the association between prescription opioid abuse and heroin use.
  This week we are scheduled to consider a series of more than a dozen 
bills that address the opioid abuse problem facing America.
  This measure reauthorizes grants from HHS's Center for Substance 
Abuse Treatment to public and nonprofit private entities that provide 
residential substance abuse treatment for pregnant and postpartum 
women, authorizing $16.9 million each year through FY 2021--$1 million 
(6%) more than the current $15.9 million authorization.
  Under the pilot grant program, proposed services for eligible 
pregnant and postpartum women would not have to be provided solely to 
women who reside in facilities.
  However, the center must specify a minimum set of services, including 
substance abuse counseling, and it must solicit stakeholder input.
  The bill directs HHS's Center for Behavioral Health Statistics and 
Quality to fund an evaluation of the pilot program at the conclusion of 
the first grant cycle.
  Under the program, grant recipients are required to provide an 
individualized plan of services for each participating woman that 
includes substance abuse counseling and certain supplemental services, 
such as pediatric health care for the woman's children.
  The measure directs the Center for Substance Abuse Treatment to carry 
out a five-year pilot grant program to help state substance abuse 
agencies address identified gaps in the services that are furnished to 
pregnant and postpartum women with substance abuse issues, and 
encourage new approaches and models of service delivery.
  H.R. 3691, the ``Improving Treatment for Pregnant & Postpartum Women 
Act of 2015,'' is a valuable piece of legislation that I encourage my 
colleagues to support.
  Additionally, I urge my colleagues to join me in sponsoring and 
supporting all legislation targeting the improvement of care for the 
prevention of infant abuse and neglect, such as H.R. 5130, the, ``Stop 
Infant Mortality and Recidivism Reduction Act of 2016'' or the 
``SIMARRA Act.''
  Mr. GENE GREEN of Texas. Mr. Speaker, I have no further requests for 
time.
  I yield back the balance of my time.
  Mr. GUTHRIE. Mr. Speaker, I encourage all of my colleagues to vote 
for H.R. 3691.
  I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Jody B. Hice of Georgia). The question 
is on the motion offered by the gentleman from Kentucky (Mr. Guthrie) 
that the House suspend the rules and pass the bill, H.R. 3691, as 
amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________